Target pre-operative INR for patients on Warfarin is <2.5. Warfarin must be stopped 5 days before the operation and be given heparin pre-operatively because warfarin has longer half life whereas heparin has half life of 12 hours and can be reversed bu Protamine su;phate.
In diabetic patients : Start insulin in sliding scale on the morning of surgery.
Prophylactic antibiotics against Infective Endocarditis should not be given routinely to people undergoing a dental or surgical procedure. Instead they should be advised to maintain good oral hygiene, and told how to recognize signs of infective endocarditis and advised when to seek expert help advice.